Over 965,000 Angioplasties are Performed Each Year in the United States

According to the latest interventional cardiology procedural analysis by iData Research, over 965,000 angioplasties are done each year in the United States. An angioplasty, also known as percutaneous coronary intervention (PCI), is a procedure that involves stent placement to open blocked or narrowing arteries.

In the past, over-stenting was heavily scrutinized, with numerous studies estimating that approximately 30% of coronary stenting procedures performed were unnecessary. As a result, the average number of stents used per PCI procedure declined as the market adjusted to the newly presented clinical evidence. Other devices and accessories associated with the procedure also experienced a decline in sales volume. “In recent years, however, procedure fluctuation has stabilized and is expected to grow at an annual rate in the low single digits between 2018 and 2024”, says Jeffrey Wong, Analyst Director at iData Research.

Procedure growth exhibits a positive effect on associated device markets. The two largest segments in the total interventional cardiology market are the coronary stent market and the vascular closure device (VCD) market. Both markets are strongly correlated with cardiac catheterization procedure volume, which, in turn, is primarily driven by PCI and angiography procedures.

A recent trend in the interventional cardiology market that is driving total PCI procedure growth is the increased focus on complex PCI patients, and the development of specialized devices and treatment techniques for patients that would otherwise be treated with coronary artery bypass graft (CABG) procedures. A particular area that manufacturers and physicians believe is not being fully addressed by interventional techniques is the complex and higher-risk indicated patient (CHIP) population.

Another recent development in the market is the transition from the hospital setting to the office-based lab (OBL) setting. Historically, the overwhelming majority of PCI procedures were performed in hospitals. However, unfavorable changes to reimbursement have contributed to a shift towards the OBL outpatient setting. Assuming that reimbursement continues to favor the OBL setting, the segment will continue to increase its share of total procedure volume over the forecast period (2018-2024).

In the past, unfavorable reimbursement conditions in the optical coherence tomography (OCT) market have significantly limited its ability to compete with intravascular imaging (IVUS) for use in PCI procedures. In January 2017, the professional or physician payment component of the procedure was added to OCT, which was previously only applicable to IVUS procedures. As a result, the percentage of PCI procedures performed using OCT is expected to grow.

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